amiodarone injection

effects on the disposition of amiodarone or DEA.

Manage hypothyroidism by reducing the amiodarone dose and considering the need for thyroid hormone supplement. In some patients, a pacemaker is required.

Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed. Expert opinion: Call your doctor for medical advice about side effects. When changing to oral amiodarone therapy, clinical monitoring is recommended, particularly for elderly patients.

Amiodarone is generally considered a class III antiarrhythmic drug, but it possesses electrophysiologic characteristics of all four Vaughan Williams classes. Combination of amiodarone with other antiarrhythmic therapy should be reserved for patients with life-threatening ventricular arrhythmias who are incompletely responsive to a single agent or incompletely responsive to amiodarone. via a central venous catheter). Since amiodarone is a substrate for CYP3A4 and CYP2C8, drugs/substances that inhibit these isoenzymes may decrease the metabolism and increase serum concentration of amiodarone. Amiodarone HCl has the following structural formula: Amiodarone HCl is a white to slightly yellow crystalline powder, and is very slightly soluble in water. Cholestyramine increases enterohepatic elimination of amiodarone and

AMIODARONE HCI INJECTION 150 mg/3 mL (50 mg/mL) 3 mL VIAL, HF Acquisition Co LLC, DBA HealthFirst measured. Amiodarone inhibits CYP2D6. After a single dose of amiodarone HCl injection in cirrhotic patients, significantly lower C max and average concentration values are seen for DEA, but mean amiodarone levels are unchanged. Amiodarone HCl injection is contraindicated in patients with known hypersensitivity to any of the components of amiodarone HCl injection, including iodine, or in patients with cardiogenic shock, marked sinus bradycardia, and second- or third-degree AV block unless a functioning pacemaker is available. studies included the following: abnormal kidney function, atrial fibrillation, Use Amiodarone Hydrochloride Injection for acute treatment until the patient's ventricular arrhythmias are stabilized.

and its use is therefore recommended. the fetus. Amiodarone may be used alone or with other medications. Recommend that patients avoid grapefruit juice, over-the-counter cough medicine (which commonly contain dextromethorphan), and St. John's Wort. Antihypertensives: Amiodarone taken concomitantly with digoxin increases the serum digoxin concentration by 70% after one day. Amiodarone HCl injection infusions exceeding 2 hours must be administered in Protease inhibitors are known to inhibit CYP3A to varying degrees. benefits of doing so for each patient. Amiodarone and DEA cross the placenta and both appear Mukilteo, WA 98275, Also supplied in the following manufacture supplied dosage forms. Cardiovasculars: The most important treatment-emergent adverse effects were hypotension, asystole/cardiac arrest/ electromechanical dissociation (EMD), cardiogenic shock, congestive heart failure, bradycardia, liver function test abnormalities, VT, and AV block. treatment groups are pooled because none of the adverse events appeared to be The maintenance infusion was continued up to hour 48. Tell your doctor about all medicines you use, especially: This list is not complete and many other drugs can interact with amiodarone. reports of the following injection site reactions: pain, erythema, edema, pigment was not affected in these studies; at the end of double-blind therapy or after Amiodarone is metabolized to the active metabolite desethylamiodarone by the cytochrome P450 (CYP450) enzyme group, specifically cytochromes P4503A4 (CYP3A) and CYP2C8. of infusion much faster than recommended have resulted in hepatocellular necrosis Amiodarone-induced hyperthyroidism usually poses a greater hazard to the patient than hypothyroidism because of the possibility of thyrotoxicosis and/or arrhythmia breakthrough or aggravation, all of which may result in death. ranges between 33% and 65%. disorders can exaggerate the degree of QTc prolongation and increase the potential a new or a worsening irregular heartbeat pattern; a light-headed feeling, like you might pass out; wheezing, cough, chest pain, trouble breathing, coughing up blood; shortness of breath (even with mild exertion), swelling, rapid weight gain; blurred vision, vision loss, headache or pain behind your eyes, sometimes with vomiting; swelling, pain, redness, or irritation around your IV needle; weight loss, thinning hair, feeling too hot or too cold, increased sweating, irregular menstrual periods, swelling in your neck (goiter); pain in your upper stomach, loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes); or. Packaging: Institutional Package Size. Amiodarone HCl injection must be delivered by a volumetric infusion pump. with careful monitoring. with increased lidocaine concentrations, has been reported with concomitant Amiodarone HCl injection in D 5W is incompatible with the drugs shown below. Proarrhythmia).

In general, dose selection for an elderly patient should be cautious, usually starting at the low end of the dosing range, reflecting the greater frequency of decreased hepatic, renal, or cardiac function, and of concomitant disease or other drug therapy. Cases of optic neuropathy and/or optic neuritis, usually resulting in visual impairment, have been reported in patients treated with oral amiodarone. fatal respiratory disorders (including distress, failure, arrest, and ARDS), supplemental infusions were given to patients in the high-dose group. The rate of the maintenance infusion may be increased to achieve effective arrhythmia suppression. Intravenous to Oral Transition). In view of the long and variable half-life of amiodarone, potential for drug interactions exists not only with concomitant medication but also with drugs administered after discontinuation of amiodarone. Reported examples of this interaction include the following: Cyclosporine (CYP3A4 substrate) administered in combination with oral amiodarone has been reported to produce persistently elevated plasma concentrations of cyclosporine resulting in elevated creatinine, despite reduction in dose of cyclosporine. The CYP3A4 isoenzyme is present in both the liver and intestines (see Advise patients that most manufacturers of corneal refractive laser surgery devices contraindicate corneal refractive laser surgery in patients taking amiodarone.

antagonists (e.g., verapamil, a CYP3A4 substrate, and diltiazem, a CYP3A4 To be sure amiodarone is not causing harmful effects, your blood will need to be tested often. 1. There have been reports of death associated with amiodarone-induced thyrotoxicosis. Product Characteristics: Not Actual Size. drugs administered after discontinuation of amiodarone.

Wort in patients receiving amiodarone could result in reduced amiodarone levels. Its vasodilatory action can decrease cardiac workload and consequently myocardial oxygen consumption. Hyperthyroidism is best identified by relevant clinical symptoms and signs, accompanied usually by abnormally elevated levels of serum T 3 RIA, and further elevations of serum T 4, and a subnormal serum TSH level (using a sufficiently sensitive TSH assay).

The systemic availability of oral amiodarone in healthy subjects

Amiodarone HCl Injection is a sterile clear, pale-yellow micellular solution visually free from particulates. hours in patients receiving the high dose).

whenever possible before being treated with intravenous amiodarone, as these administration in patients with VT and VF ranged between 220 and 440 mL/h/kg. See labeling for oral amiodarone.

Give a list of all your medicines to any healthcare provider who treats you. The risk of exposing the infant to amiodarone should be weighed

if you have a pacemaker or defibrillator implanted in your chest.

mg/L. Amiodarone is metabolized to desethylamiodarone by the cytochrome P450 (CYP450) Polysorbate 80, a component of Amiodarone Injection, is also known to leach DEHP from PVC [see Description (11)]. Amiodarone injection is often given directly into a large vein in the upper chest (central IV line). complication of long-term amiodarone use (see labeling for oral amiodarone). for this adsorption.

The need to coadminister amiodarone with any other drug known to prolong the QTc interval must be based on a careful assessment of the potential risks and benefits of doing so for each patient. The most important adverse reactions were hypotension, asystole/cardiac arrest/pulseless electrical activity (PEA), cardiogenic shock, congestive heart failure, bradycardia, liver function test abnormalities, VT, and AV block. amiodarone, grapefruit juice should not be taken during treatment with oral This may lead to low amiodarone serum levels and potential decrease in efficacy. Renal Impairment: Renal disease does not influence the pharmacokinetics of amiodarone or DEA. Other antiarrhythmic drugs, such as quinidine, procainamide, disopyramide, These recommendations are made on the basis of a similar total body amount of amiodarone delivered by the intravenous and oral routes, based on 50% bioavailability of oral amiodarone. If you are a consumer or patient please visit

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Amiodarone taken concomitantly with quinidine increases quinidine serum concentration by 33% after two days. Amiodarone Hydrochloride Injection contains Amiodarone Hydrochloride (C25H29I2NO3•HCl), a class III antiarrhythmic drug. You should not receive this medicine if you are allergic to amiodarone or iodine, or if you have a serious heart condition such as "AV block" (unless you have a pacemaker), a history of slow heart beats, or if your heart cannot pump blood properly. clinical trials are conducted under widely varying conditions, adverse reaction rates observed in the clinical trials of a drug cannot be directly compared to rates in the clinical trials of another drug and may not reflect the rates observed in practice. Patients whose arrhythmias have been suppressed by amiodarone may be switched to oral amiodarone.

NIH be administered over 10 minutes to minimize the potential for hypotension. Nexterone® is a novel IV amiodarone formulation, proved to be devoid of hypotensive effects in clinical studies and may represent an improved and safer instrument in this setting. numbness and tingling in your hands or lower legs. Amiodarone and one of its major metabolites, desethylamiodarone (DEA), are excreted in human milk, suggesting that breastfeeding could expose the nursing infant to a significant dose of the drug. Available studies demonstrated a convincing efficacy of IV amiodarone in ventricular arrhythmias and cardiac arrest.

HCI injection through a peripheral vein irrespective of dose regimen. Intravenous amiodarone has been reported to produce inotropic and vasodilatory effects in animals and humans. Vial Size: 20 mL. amiodarone in clinical studies had baseline liver enzyme elevations, and 13% electrophysiologic characteristics of all four Vaughan Williams classes. Talk to your doctor before taking any medication during this time. Amiodarone must be delivered by a volumetric infusion pump. ventricular arrhythmias are stabilized.

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